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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 42-year-old white man had headache, fever, chills, abdominal pain, nausea and vomiting, night sweats, and dark urine for 3 days before admission; he had history of a tick bite 6 weeks earlier. Progressive systemic deterioration, heralded by progressive hepatosplenomegaly and pancytopenia, occurred despite doxycycline therapy. Subsequent recovery was preceded by progressive resolution of hepatosplenomegaly. Progressive hepatosplenomegaly has not been previously reported in association with systemic monocytic ehrlichiosis.
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PMID:Systemic ehrlichiosis presenting as progressive hepatosplenomegaly. 919 48

Human monocytic ehrlichiosis is a recently described tick-borne infection with the rickettsial organism Ehrlichia chaffeensis. We describe a patient with documented E chaffeensis infection and multiple organ system involvement. Prominent neurologic symptoms and signs included severe headache, meningismus, and altered mental status. Additional neurologic findings included unilateral arm weakness and a Bell's palsy. Biopsy of brain and meninges demonstrated an infiltrate of atypical lymphoid cells in the leptomeninges with involvement of blood vessel walls and extension into the Virchow-Robin spaces. Bone marrow biopsy revealed fibrin-ringed granulomas. The patient also developed a nonspecific increase in immunoglobulin production. Host immune response may play a critical role in the pathophysiology of ehrlichiosis.
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PMID:A case of acute monocytic ehrlichiosis with prominent neurologic signs. 919 77

Human monocytic ehrlichiosis and human granulocytic ehrlichiosis are emerging tick-borne infections in the United States. The clinical presentations of these two distinct, potentially life-threatening infections are fever, headache, myalgia, and other diagnostically nonspecific symptoms. Physician awareness is lacking and appropriate diagnostic tests are still not widely available. Because few documented cases have been autopsied, the pathology of human monocytic ehrlichiosis and human granulocytic ehrlichiosis is incompletely described. In human monocytic ehrlichiosis, bone marrow and hepatic granulomas and multiorgan perivascular lymphohistiocytic infiltrates have been observed. In human granulocytic ehrlichiosis, opportunistic fungal and viral infections have been important findings. To expedite an analysis of the pathology and pathogenesis of the human ehrlichioses, it is proposed that a Registry of Pathology of Human Ehrlichioses be established.
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PMID:Human monocytic and granulocytic ehrlichioses. Discovery and diagnosis of emerging tick-borne infections and the critical role of the pathologist. 927 5

Human ehrlichioses are tick-borne infections caused by bacteria in the genus Ehrlichia. Human monocytic ehrlichiosis is caused by Ehrlichia chaffeensis and human granulocytic ehrlichiosis is caused by an agent similar to Ehrlichia equi. E. chaffeensis infects mononuclear phagocytes and is transmitted by Lone Star ticks (Amblyomma americanum) found in the south central and eastern United States. The agent of human granulocytic ehrlichiosis infects mostly neutrophils, it transmitted by Ixodes species ticks, and occurs mostly in the upper midwest and northeast United States. Despite the undifferentiated presentation of both ehrlichioses with fever, headache, myalgias, leukopenia, thrombocytopenia, and elevated liver enzyme activities, the diagnostic methods are distinct. Occasional severe complications include meningoencephalitis, adult respiratory distress syndrome, shock, and opportunistic infections. Immunocompromised patients are at high risk for death. An adverse outcome is associated with delayed diagnosis and therapy; thus, empirical treatment is advocated. Treatment with doxycycline usually results in prompt defervescence and cure.
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PMID:Human ehrlichioses: newly recognized infections transmitted by ticks. 950 59

In the United States, human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) represent two clinically indistinguishable yet epidemiologically and etiologically distinct diseases caused by Ehrlichia chaffeensis and a bacterium similar or identical to E. equi, respectively. Infection with these emerging tickborne pathogens results in acute, influenza-like illnesses with fever, headache, malaise, and frequently leukopenia and/or thrombocytopenia. Connecticut and New York have initiated statewide laboratory-based surveillance to determine the magnitude and geographic extent of ehrlichiosis. This report summarizes results from the first 3 years of surveillance, which showed that rates of ehrlichiosis were similar in counties in both states where the disease occurs, and highest age-specific rates occurred among persons aged >40 years.
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PMID:Statewide surveillance for ehrlichiosis--Connecticut and New York, 1994-1997. 964 34

Human Granulocytic Ehrlichiosis (HGE) is a recently described human illness in the US which manifests as fever, myalgia and headache combined with pancytopenia and elevated concentrations of hepatic transaminases. Genetic analyses indicate that the agent of HGE appears to be an Ehrlichia species that is closely related to E. equi and E. phagocytophila. Ixodes dammini and I. scapularis were identified as potential vectors of HGE. Ixodes ticks are also the vector of Borrelia burgdorferi, the agent of Lyme borreliosis. The presence of antibodies against Ehrlichia in 132 sera from Danish patients with definite Lyme neuroborreliosis were examined in order to provide immunoserologic evidence of this infection in Denmark. Patients with Lyme neuroborreliosis were chosen as a test cohort, as these patients had been infested by a tick sufficient for transmission of B. burgdorferi. All had cerebrospinal fluid lymphocytic pleocytosis. As controls, serum samples from 50 healthy Danish blood donors were included. Of the 132 patients with Lyme neuroborreliosis, 5 (3.8%) reacted with the E. equi antigen substrate at titres 1:128. None of the blood donors were found seropositive for E. equi. At least 2 of the patients found seropositive for HGE constituted probable cases of HGE with E. equi antibody titres of at least 80 combined with fever, headache and myalgias. However, in no cases were we able to detect the presence of the HGE agent in the serum by PCR. We conclude that human exposure to granulocytic Ehrlichiae species may also occur in Europe, although further studies will be necessary to document active infection with these potential pathogens.
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PMID:Immunoserologic evidence of Human Granulocytic Ehrlichiosis in Danish patients with Lyme neuroborreliosis. 973 Mar 6

A 69-year-old male presented at a first-aid department in Connecticut (USA) with severe headache, fever and myalgia of three days' duration. Just before he became ill, an engorged tick had been noted on his back and removed. Laboratory results included a decreased white cell count and platelet count and elevated transaminases. So-called morulae consisting of microorganisms were detected in a peripheral blood smear of the day of admission. Treatment for human granulocyte ehrlichiosis with doxycycline for two weeks resulted in prompt and full recovery and after four weeks repeat laboratory tests were all within normal limits. Human granulocyte ehrlichiosis should be considered in a patient with a recent tick bite who develops fever, headache and myalgias, in the presence of leukopenia or thrombocytopenia, even in Western Europe.
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PMID:[Human granulocytic ehrlichiosis, a tick-borne disease]. 985 44

A case of human ehrlichiosis is presented. This case review emphasizes the need for a thorough history and physical examination in all patients who present with relatively non-specific complaints such as headaches, chills, myalgias, and arthralgias. These complaints should elicit the question of recent tick exposure from the clinician, particularly if the area is endemic for various rickettsial diseases. Laboratory findings such as leukopenia, thrombocytopenia, and increased hepatic enzymes should strongly suggest the disease.
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PMID:Ehrlichiosis. 995 Mar 82

Ehrlichiosis is the potentially life-threating infection. It is caused by obligate intracellular bacteria. The clinical presentations are fever, headache, myalgia, malaise, nausea, vomiting and other nonspecyfic symptoms. Some patients develop neurologic symptoms and signs. The are two distinct forms of human ehrlichiosis: human monocytic ehrlichiosis /HME/--cased by Ehrlichia chaffeensis that infects mononuclear phagocytes and human granulocytic ehrlichiosis /HGE/--caused by E. species closely related to E. phagocytophyla and E. equi and infects granulocytes. Successful treatment of these infections may depend on proper diagnosis. Appropiate diagnostic tests are still not available. This diagnisis should be considered in febrile patients with tick bites.
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PMID:[Ehrlichiosis: a tick-born infection]. 1033 86

Ehrlichiosis is an emerging zoonotic disease transmitted to man by ticks. Its clinical features include fever, headache, myalgia, nausea and rash. The diagnosis requires a high index of suspicion; the disease has a specific serology, and has never been reported in Israel. We describe a 52-year-old man hospitalized with fever, a diffuse rash, arthralgia and epididymitis. Skin biopsy disclosed necrotizing small vessel disease consistent with periarteritis nodosa. Acute phase serum titer for E. chaffeensis was 1:256. Fever promptly subsided following ciprofloxacin.
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PMID:[Monocytic ehrlichiosis--an emerging zoonotic disease in Israel]. 1095 83


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